{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:54:59Z","timestamp":1792565699402,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n \n The US Supreme Court\n Dobbs v Jackson Women\u2019s Health Organization<\/jats:italic>\n decision allowed states to strengthen restrictions on abortion access, triggering the closure of family planning clinics and leading to confusion about the legality of emergency contraceptives (ECs).\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To evaluate the association between the\n Dobbs<\/jats:italic>\n decision and fills for oral and emergency contraceptives in states that enacted the most restrictive abortion policies after\n Dobbs.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This cohort study used data on contraceptive fills for women of reproductive age (15-49 years) in the US from IQVIA\u2019s National Prescription Audit PayerTrak and data from the Guttmacher Institute were used to categorize changes in abortion restrictions in each state. A difference-in-differences analysis compared changes in monthly fill rates for daily oral contraceptive pills (OCPs) and ECs in states that became most restrictive (implemented a full abortion ban after\n Dobbs<\/jats:italic>\n ) and comparison states (kept a medium level of abortion restrictions after\n Dobbs)<\/jats:italic>\n before (March 2021 to November 2021) and after (July 2022 to October 2023) the\n Dobbs<\/jats:italic>\n decision.\n <\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n State-level abortion restrictions.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Monthly fills of OCPs and ECs per 100\u202f000 women of reproductive age.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Between March 2021 and October 2023, 142.8 million prescriptions for OCPs and 904\u202f269 prescriptions for ECs were dispensed at US retail pharmacies. Before\n Dobbs<\/jats:italic>\n , trends in monthly fill rates were similar for OCPs and ECs between the most restrictive and comparison states. After the\n Dobbs<\/jats:italic>\n decision, states that became the most restrictive experienced an additional 4.1% decline in OCP fills with 285.9 fewer fills per 100\u202f000 (95% CI, \u2212495.8 to \u22126.8;\n P<\/jats:italic>\n \u2009=\u2009.04). In contrast to OCPs, fills for ECs increased during the first year after\n Dobbs<\/jats:italic>\n (July 2022 to June 2023) in both groups of states. However, 1 year after\n Dobbs<\/jats:italic>\n (July 2023 to October 2023), the most restrictive states experienced an additional 65% decrease in emergency contraceptive fills with 13.2 fewer fills per 100\u202f000 (95% CI, \u221227.2 to \u22124.1;\n P<\/jats:italic>\n \u2009=\u2009.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n In this cohort study of prescriptions filled at US pharmacies, the\n Dobbs<\/jats:italic>\n decision was associated with declines in oral contraceptives, particularly ECs, in states enacting the most restrictive abortion policies. Given the important role of OCPs and ECs in preventing pregnancy and the need for abortion, efforts to improve access may be needed, especially in states where legal abortion is no longer an option.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.18620","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T11:37:00Z","timestamp":1719401820000},"page":"e2418620","source":"Crossref","is-referenced-by-count":47,"title":["Use of Oral and Emergency Contraceptives After the US Supreme Court\u2019s\n Dobbs<\/i>\n Decision"],"prefix":"10.1001","volume":"7","author":[{"given":"Dima M.","family":"Qato","sequence":"first","affiliation":[{"name":"Program on Medicines and Public Health, Alfred Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles"},{"name":"Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Myerson","sequence":"additional","affiliation":[{"name":"Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles"},{"name":"Department of Population Health Sciences, University of Wisconsin, Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Shooshtari","sequence":"additional","affiliation":[{"name":"Program on Medicines and Public Health, Alfred Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny S.","family":"Guadamuz","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management, University of California at Berkeley School of Public Health, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Caleb","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"issue":"9","key":"zoi240610r1","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1056\/NEJMsa1506575","article-title":"Declines in unintended pregnancy in the United States, 2008-2011.","volume":"374","author":"Finer","year":"2016","journal-title":"N Engl J Med"},{"issue":"1","key":"zoi240610r3","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1363\/psrh.2017.49.issue-1","article-title":"Contraceptive failure in the United States: estimates from the 2006-2010 national survey of family growth.","volume":"49","author":"Sundaram","year":"2017","journal-title":"Perspect Sex Reprod Health"},{"key":"zoi240610r4","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2023.100662","article-title":"Estimates of use of preferred contraceptive method in the United States: a population-based study.","volume":"30","author":"Gomez","year":"2024","journal-title":"Lancet Reg Health Am"},{"issue":"5","key":"zoi240610r7","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2020.0605","article-title":"Supreme Court to decide fate of Affordable Care Act contraceptive coverage mandate.","volume":"1","author":"Turret","year":"2020","journal-title":"JAMA Health Forum"},{"issue":"4","key":"zoi240610r16","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.whi.2023.04.002","article-title":"A focus on contraception in the wake of Dobbs.","volume":"33","author":"Salganicoff","year":"2023","journal-title":"Womens Health Issues"},{"issue":"8","key":"zoi240610r19","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.2257","article-title":"The FDA declares levonorgestrel a nonabortifacient-a 50-year saga takes a decisive turn.","volume":"4","author":"Adashi","year":"2023","journal-title":"JAMA Health Forum"},{"issue":"1","key":"zoi240610r20","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1186\/s12978-021-01289-3","article-title":"The impact of US policy on contraceptive access: a policy analysis.","volume":"18","author":"Swan","year":"2021","journal-title":"Reprod Health"},{"key":"zoi240610r23","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.jpubeco.2018.08.009","article-title":"The impacts of reduced access to abortion and family planning services on abortions, births, and contraceptive purchases.","volume":"167","author":"Fischer","year":"2018","journal-title":"J Public Econ"},{"issue":"6","key":"zoi240610r24","doi-asserted-by":"publisher","first-page":"2555","DOI":"10.1007\/s11113-022-09740-4","article-title":"A prospective cohort study of changes in access to contraceptive care and use two years after Iowa Medicaid coverage restrictions at abortion-providing facilities went into effect.","volume":"41","author":"Kavanaugh","year":"2022","journal-title":"Popul Res Policy Rev"},{"issue":"20","key":"zoi240610r26","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1001\/jama.2022.20424","article-title":"Estimated travel time and spatial access to abortion facilities in the US before and after the Dobbs v Jackson Women\u2019s Health decision.","volume":"328","author":"Rader","year":"2022","journal-title":"JAMA"},{"issue":"2","key":"zoi240610r33","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxae016","article-title":"Has the fall of Roe changed contraceptive access and use? 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The U.S. abortion rate continues to drop: once again, state abortion restrictions are not the main driver. Guttmacher Institute. 2019. Accessed May 20, 2024. https:\/\/www.guttmacher.org\/sites\/default\/files\/article_files\/gpr2204119.pdf"},{"key":"zoi240610r5","unstructured":"Guttmacher Institute. Contraceptive use in the United States by method. Published May 2021. Accessed May 20, 2024. https:\/\/www.guttmacher.org\/fact-sheet\/contraceptive-method-use-united-states"},{"key":"zoi240610r6","unstructured":"Guttmacher Institute. The federal contraceptive coverage guarantee: an effective policy that should be strengthened and expanded. 2021. Accessed May 20, 2024. https:\/\/www.guttmacher.org\/fact-sheet\/contraceptive-coverage-guarantee"},{"key":"zoi240610r8","unstructured":"Guttmacher Institute. Insurance coverage of contraceptives. Published July 1, 2023. 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Accessed May 5, 2024. https:\/\/www.washingtonpost.com\/nation\/2022\/06\/24\/birth-control-access-supreme-court-abortion-ruling\/"},{"key":"zoi240610r17","unstructured":"Kaiser Family Foundation. The right to contraception: state and federal actions, misinformation, and the courts. Accessed April 19, 2024. https:\/\/www.kff.org\/womens-health-policy\/issue-brief\/the-right-to-contraception-state-and-federal-actions-misinformation-and-the-courts\/"},{"key":"zoi240610r18","unstructured":"Kaiser Family Foundation. KFF Health Tracking Poll\u2014Early 2023. Accessed April 19, 2024. https:\/\/www.kff.org\/womens-health-policy\/poll-finding\/kff-health-tracking-poll-early-2023\/"},{"key":"zoi240610r21","unstructured":"Guttmacher Institute. Reproductive health impact study. Accessed May 20, 2024. https:\/\/www.guttmacher.org\/reproductive-health-impact-study"},{"key":"zoi240610r25","unstructured":"Kirstein? M, Dreweke? J, Jones? RK, Philbin? J. 100 days post-Roe: at least 66 clinics across 15 US states have stopped offering abortion care. Guttmacher Institute. 2022. Accessed April 12, 2023. https:\/\/www.guttmacher.org\/2022\/10\/100-days-post-roe-least-66-clinics-across-15-us-states-have-stopped-offering-abortion-care"},{"key":"zoi240610r27","unstructured":"KFF. Community health centers and family planning in an era of policy uncertainty: report. Kaiser Family Foundation. Accessed April 19, 2024. https:\/\/www.kff.org\/report-section\/community-health-centers-and-family-planning-in-an-era-of-policy-uncertainty-report\/"},{"key":"zoi240610r28","unstructured":"The White House. Fact sheet: President Biden issues executive order on strengthening access to contraception. The White House. June 23, 2023. Accessed April 19, 2024. https:\/\/www.whitehouse.gov\/briefing-room\/statements-releases\/2023\/06\/23\/fact-sheet-president-biden-issues-executive-order-on-strengthening-access-to-contraception\/"},{"key":"zoi240610r29","unstructured":"Weixel? N. Biden to sign executive order to expand birth control access. The Hill. Published June 23, 2023. Accessed May 20, 2024. https:\/\/thehill.com\/homenews\/administration\/4063872-biden-to-sign-executive-order-to-expand-birth-control-access\/"},{"key":"zoi240610r30","unstructured":"Stolberg? SG. A year after dobbs, advocates push in the states for a right to birth control. The New York Times. June 17, 2023. Accessed May 20, 2024. https:\/\/www.nytimes.com\/2023\/06\/17\/us\/politics\/birth-control-dobbs-clarence-thomas.html"},{"key":"zoi240610r31","unstructured":"The New York Times. Women on why they\u2019re stocking up on the morning-after pill. Sales of the emergency contraceptive surged after the Supreme Court\u2019s decision to overturn Roe v. Wade. June 27, 2022. Accessed April 19, 2024. https:\/\/www.nytimes.com\/2022\/06\/27\/style\/plan-b-stockpile-roe-abortion.html"},{"key":"zoi240610r32","unstructured":"Ranji? U, Gomez? I, Salganicoff? A, Rosenzweig? C, Kellenberg? R, Gifford? K. Medicaid coverage of family planning benefits: findings from a 2021 state survey. Kaiser Family Foundation. Published February 17, 2022. 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